HFMA announced the release of a draft of new best practices that will bring more consistency, clarity, and transparency to patient financial interactions. The guidelines were released during ANI: The Healthcare Finance Conference, held June 16-19 in Orlando, Fla. The proposed guidelines are open for public comment until July 31. 

Revenue Cycle Strategist subscribers are encouraged to comment on the draft guidelines at pfibestpractices.com.

The draft of Patient Financial Interaction (PFI) best practices can be viewed online at pfibestpractices.com, where comments on the proposed best practices may be submitted. Patient feedback also will be solicited in the coming months. The resulting final practices will be released in the fall for voluntary adoption by healthcare organizations across the country.

How the Guidelines Were Created

The proposed best practices were created by a steering committee that met monthly over the past year and included leaders from HFMA, the National Patient Advocate Foundation, the American Hospital Association, Harvard Medical School, and America’s Health Insurance Plans, among others. 

The PFI project was overseen by an advisory panel consisting of Sen. Tom Daschle, Sen. Bill Frist, former Secretary of Health and Human Services Donna Shalala, Gov. Michael Leavitt, and attorney Jamie Gorelick. Leavitt Partners facilitated the Steering Committee process.

“Healthcare financial interactions can be complex and confusing because of complicated payment structures, dozens of different payers and forms, and varied government programs,” said Joseph J. Fifer, FHFMA, CPA, president and CEO of HFMA. “When you add the reality that patients are becoming responsible for greater proportions of their healthcare costs, clear guidelines and communication are more important than ever. These best practices are a critical component of HFMA’s ongoing effort to establish more consistent financial practices that are fair to all stakeholders while helping patients access and pay for the health care they need.” 

The proposed best practices focus on financial interactions when medical services are scheduled as well as when emergency and non-emergency care is delivered. These practices provide guidance regarding when and how communication should take place about patient insurance coverage, financial counseling, patient financial responsibility for service, and any existing balance the patient may have. The best practices emphasize open and early communication, the sharing of clear information, and the identification of a path for financial resolution that is fair for patients and healthcare organizations alike. 

“Patients and their families enter the healthcare system when they are most vulnerable, and then they encounter financial processes that are challenging even to veteran healthcare professionals,” said Nancy Davenport-Ennis, president and CEO of the National Patient Advocate Foundation and a member of the group that developed the best practices. “The early, clear financial conversations described in these best practices will help give patients peace of mind and help providers receive appropriate payment—both key objectives for the healthcare system to function with fairness and compassion.”

“Clear financial communication between patients and healthcare organizations is the right thing to do for all concerned, but our complex healthcare system makes clarity a challenge,” says Bert R. Zimmerli, executive vice president and CFO at Intermountain Healthcare and a member of the steering committee. “These best practices provide a guidepost that our industry will use to continuously improve these crucial financial interactions.”

What’s Next

HFMA will now move the project through implementation with the support of steering committee members. The project is one of a group of HFMA initiatives designed to promote fair and responsible financial practices in health care. 

Publication Date: Wednesday, July 03, 2013